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近年随着对四肢恶性软组织肿瘤保肢治疗概念的提出及临床推广应用,目前多数患者可在化疗的保护下,既可彻底切除肿瘤又能保留肢体。我院自1993年起应用以氮烯眯胺为主组成的化疗方案治疗恶性软组织肿瘤收到良好的近期疗效。现报告如下: 1 材料与方法 1.1 一般资料 本组共19例中男13例,女6例,平均年龄37.5岁(22～60岁),均属恶性软组织肿瘤,其中横纹肌肉瘤及恶性纤维组织细胞瘤各5例,滑膜肉瘤8例,黄色肉芽肿1例。部位:股部9例,臀部4例,膝部足跟部各2例,小腿外侧、足背部各1例。所有诊断均经术后病理学证实。病变大小:2cm×1cm×1cm～15cm×13cm×10cm。 1.2 治疗方法 术式及例数:肿瘤扩大切除术17例,肿瘤扩大切除带蒂皮瓣修复术2例。术后切口均Ⅰ期愈合,于术后14天开始应用CVADIC方案进行化疗,具体用法:CTX:600mg/m~2,第1天,VCR:1.5mg/m~2,第1、5天,ADR:40mg/m~2,第1天,DITC:200mg/m~2,第1～5天。半年内每个月1次,半年至1年半内每3个月1次,1年半至2年半内每6个月1次,以后定期复查,并根据具体情况调整治疗方案。用药过程中均出现恶心,呕吐,10例出现不同程度的骨髓抑制,经支持对症治疗后好转,无肝、肾功能损害。16例于术后2周行外照射,剂量为40～60Gy。
In recent years, with the concept of limb salvage limb salvage limb salvage and the clinical application of popularization and application, the current majority of patients can be under the protection of chemotherapy, both complete removal of the tumor can retain limbs. Our hospital since 1993, the application of prednisolone amine-based chemotherapy regimen for the treatment of malignant soft tissue tumors received a good short-term efficacy. Now report as follows: 1 Materials and Methods 1.1 General Information The group of 19 patients, 13 males and 6 females, average age 37.5 years (22 to 60 years), are malignant soft tissue tumors, including rhabdomyosarcoma and malignant fibrous tissue cells 5 cases of tumor, 8 cases of synovial sarcoma, 1 case of yellow granuloma. Parts: 9 cases of hip, 4 cases of hip, 2 cases of knee heel and 1 case of lateral and dorsal foot. All diagnoses were confirmed by postoperative pathology. Lesions size: 2cm × 1cm × 1cm ~ 15cm × 13cm × 10cm. 1.2 Therapeutic method and the number of cases: 17 cases of tumor enlargement and resection, tumor expansion and removal of pedicle flap repair in 2 cases. The wounds were healed by first intention and the CVADIC regimen was started on the 14th day after the operation. The specific usage was CTX: 600mg / m 2, day 1, VCR: 1.5mg / m 2, day 1, ADR: 40mg / m ~ 2, the first day, DITC: 200mg / m ~ 2, the first ~ 5 days. Within six months, once a month, once every three months within six months to a year and a half, once every six months for a year and a half to two and a half years, after regular review, adjust the treatment plan according to the specific circumstances. Nausea and vomiting were observed during the course of medication, and bone marrow suppression was observed in 10 patients with varying degrees of myelosuppression. After the symptomatic treatment was improved, the liver function and liver function were not impaired. Sixteen patients underwent external irradiation two weeks after operation at a dosage of 40-60 Gy.